Mandy, if you are in a rural or semi-rural area, you may be able to find someone with a chaff cutter who can chaff your safe hay for you.
As we have mentioned, beet pulp and soy hulls can make up a large percent of the diet as well, and you may be able to use a safe pelleted feed such as Hygain Zero to sprinkle on top as a taste-tempter. 
Look into the Multicube teff+lucerne hay cubes also, as they might be useful in small quantities. 
A half cup or so of psyllium husks soaked with the beet pulp and/or soy hulls then mixed with the chaff or soaked hay cubes makes the soft feed a bit 'slimy' and reduces the risk of choke. 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

He has had ad lib hay but I've just been told by dentist he is not able to chew properly anymore and it is therefore a choke and colic hazard . 

I thought maybe to soak to soften it, or someone suggested cutting it up .. anyone had experience with this. I can cut and or soak but need to work out a viable method ..

Hi Mandy. My 40'ish horse with PPID and I/R lost his ability to chew hay over 5 years ago. I tried all of the suggestions above...took hay to a man who had a chopper for his alpacas, he chopped up a couple bales for me. Bought an office style paper cutter, and actually sat in the barn chopping hay. Used hedge trimmers. You name it, I probably tried it. When they have lost enough of the grinding surface/molars are smooth they just can't do it anymore, and believe me, I tried very very hard to make something work.

My only option was to go to Ontario Dehy Timothy Balanced Cubes (ODTBC). I don't know if they are available in Australia, but others can probably tell you yes or no or a suitable alternative. These hay cubes are weighed like you would hay to determine how much is needed a day and then each feeding is soaked, so your horse/pony actually eats hay mush. I also mix in Rinsed/Soaked/Rinsed non-molasses beet pulp. Except for certain other specific to need supplements (and of course pergolide...up to 6.5 mg compounded) this works, but I warn you in advance, it is expensive and time consuming. But without the cubes, my horse would not be alive. Because the ODTBC are *balanced* you don't need to worry about adding different minerals or other supplements to balance your hay.

I would think hoof boots are most definitely a necessity. Different hooves seem to like different brands/types of boots. I have been most happy with Easy Boot Clouds. I used their standard insert at first, but am now using different brands of inserts that my horse seems to prefer.

I wish you the best!!

 

--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

Hi, Mandy,

I had a mare who had colic surgery last summer. She could only digest small bites of hay. I had great success using a leaf mulcher.
I just put the hay in the tube, turned it on, and it came out in small bits. I fed this for 6 months.
Kathy Thomas


--
Kathy 2017 and Donna

Harrowsmith, Ontario

https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Donna

Hi Mandy,

There are some message threads in our Horsekeeping sub-group on chopping hay.  Here is one particularly helpful one.
https://ecir.groups.io/g/Horsekeeping/topic/85085668#29957
If you do chop it, I would try wetting it to keep the dust down.  Chopped hay can have lots of fine particles so make sure you wear a mask handling it dry and chopping it.  Speaking from personal experiences with handling mechanically chopped hay.  You can also use scissors for now, fortunately a mini doesn't eat as much as a full size horse!

R/s/r beet pulp can replace up to a third of the hay in his diet.  It is one of your safest options, but you do need to have the mineral balancing updated to offset the added calcium from the beet pulp.  I'm not familiar with Maxisoy but that could potentially make up a large portion of the diet, too, since it is also safe to feed.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

--
Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974

Hi, Mandy,
On Flozin drugs/SGLT-2 inhibitors, I urge you to send an email to DrKellon at gmail dot com. Use the usual web addressing that I can't show here because Groups.io mungs email addresses to protect privacy. The Subject line: Flozin drug for Australian pony. Provide her with your vet's email address. Please read the feeding information she provides very carefully. Equines on SGLT-2 inhibitors do best when fed ample amounts of safe hay. Those of us who have fed our EMS equines restricted diets for years need to relearn how to feed when we start these drugs. I do NOT restrict my horse's hay with an ultra-slow hay net. I do net the hay so it isn't wasted. As it turns out, my horse can't eat more than 1.85% of her body weight when supplemented with appropriate quantities of beet pulp.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Hi Mandy,

Please have your vet email "drkellon at gmail dot com" to get the details on how to feed a horse on Ertugliflozin.  Have your vet CC you so you can get the info, too.  On this drug he needs unrestricted calories and as much beet pulp as he will eat.  There are other supplements as well as blood and urine testing protocols that should be followed.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Mandy, breathe! Don't panic.
Step 1: remove the unsuitable feeds from his diet right now (see my suggestions below in this thread); yes I would try soaked hay in a small-mesh net so that he can get little tiny bites. Don't soak the heck out of it, an hour in cold water is plenty. Right now I wouldn't stress about mineral balancing, just get safe calories and fluids into him. Beet pulp and maxisoy are your friends, especially as he is on the ertugliflozin (see link to Dr K's message below)
Step 2: support his feet with pads or soft footing or pads in boots; you can use disposable nappies doubled up if need be, or foam taped on. 
Step 3: have you increased his prascend? if so, get a blood test for ACTH done so you know if you need to increase further; if not, increase it.
Step 4: while you are getting ACTH tested, ask your vet to test for insulin and triglycerides; see this message from Dr Kellon regarding the feeding of horses on the --flozin drugs (which includes ertugliflozin=Steglatro) https://ecir.groups.io/g/main/message/277923
There are other threads also.
To search the Messages, go to the Search bar at the top of the page and type in a word. "Ertugliflozin" brings up a number of threads. 

You have your subscription set to email "Digest", which means you may miss replies to your questions if you don't check the whole email every day. If you're accessing the group on a mobile phone, you can download the Groups.io app, which makes seeing the messages easier. Or you can go to the website on your computer. 

And breathe!

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

Oh my god, only just saw this advice. 

He has got lots worse and I was contacting you guys about what I can do. Now I'm realising its what I'm feeding him - ugh - ..I want to cry. Are facing putting him down as he is now leaning back and is clearly super uncomfortable on both fore feet. I haven't seen him lie down for ages. I can't believe I have so stuffed it up. I got new foot photos but I'm pretty sure they won't bee good enough angles/quality. he has had treatement on his soles to address fungus and it is very hard to get it off, so it obscures the view. I will try to get more photos of his bad foot now. The better foot I can't lift as he is not weight baring on the other one. I can get side angles though. 

So in relation to feed - you say increase his beet pulp, add psyllium and Energreen maxisoy with groud linseeds. is this right - can someone advise? I just noticed the 'Safe foods file so will look at that too. The feed has been balanced by Carol Layton. Should I recontact her about these additions, as clearly that's what I should have done first before I changed the diet. I have asked her and the only suggest she made was to add beet pulp - he just stops eating it of nothign else is added.  
Note - he is on the flozin drug - I have been told Dr Kellon has advice about diet in relation to this drug, how do I find this? 


What was driving me adding additional items of feed to his diet is that the dentist feels there is a significant choking hazard with his teeth and he should have no hay. therefore other than my additional feed, what is he meant to eat? Can i give him soaked hay (it is low sugar) as if it is soaked it will be softer and put it in a slow feeding hay net so he takes small bites. 

I am getting to the end here - so disheartened and down on myself for not doing better. he is now in so much pain. He has positioned himself with his feet up an incline and his feet down the dip, I think he is takign weight off his fore feet. I haven't seen him sit down at all.  Is there anythign I can give him for the pain. I know you say no bute but what else. I have tried him on devils claw that didn't seem to help. I have him on ALCAR due to muscle wastage..what else ? 

Now he's going to have to come back from my mistake, and he is still so think. Mostly he has been quite perky throughout this but he is not anymore. 

I will tgo out now and get photos but any advice you can provide woudl be much appreciated. 

mandy 


 
--
Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974

Thank you for this advice. Can you tell me how I find/search for this information. 

thank you 


Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974

--
Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974

I agree with Maxine. I have seen radiographs this bad that belonged to ponies that were reasonably comfortable but she will have to grow out a much longer foot. Keep backing up the toe but do not remove length from the bottom of the hoof for now. Do you have boots?

You should concentrate on the obvious issues in front of you - a 28 YO Shetland with PPID, EMS and advanced founder. More pergolide and getting the diet controlled are the priorities. I don't know where that boron information came from but much of it is flat out wrong - e.g. boron can form corticosteroids. There are no  magical fixes for this. Once you get the dietary ingredients sorted out, contact Carol Layton at Balanced Equine https://balancedequine.com.au/ .

No access to high oxalate grasses for either one of them.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Just a reminder that while in ertugliflozin the dietary needs may increase. Please search posts for Dr K's guidance on this.hia weight loss is a sign a change may be needed.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Hi Mandy
If the vet means Mitavite Gumnuts, they are NOT suitable for a PPID or EMS horse. They are 18% starch, which will raise insulin. Fibre Essentials isn't great either, with up to 15% starch. Starch digests directly to glucose.
Can you increase his beet pulp more? You could also add soyhull pellets such as Energreen Maxisoy. These are both great foods for boosting weight and have safe ESC+starch levels. 
Multicube make a teff+lucerne hay cube that may be useful as well, provided he has not been sore on lucerne before. Unfortunately they don't make a straight teff cube (I don't think anyone does). They don't have a guaranteed ESC+starch level for each batch, but they do test regularly and I feed these cubes without any issues. 
We don't have a great choice in hay cubes or pellets here. Did the dentist say no chaff either? Or just no hay? If he can eat chaff, you might be able to soak a bit of chaff and mix it with the beet pulp/soyhulls so that he gets some longer-stem fibre. I've found that adding a couple of tablespoons of psyllium husk to the beet pulp then mixing with the soaked hay cubes seems to make the whole mixture easier for the oldies to chew. Psyllium is a good source of soluble fibre as well. 

Not sure why you changed to linseed oil from linseeds--grinding the seeds increases the digestibility and you can feed up to a cup of ground linseeds per day. The seeds have a lot of nutritious factors in them as well as the oil, so for weight gain I would go for the seeds. 

IMO getting the diet sorted (including correct mineral balancing), addressing trim issues and increasing his pergolide to get the ACTH in range will do more for stopping further bone loss and restoring circulation than anything else.

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

Hello all

I've now added Xrays. You can see the bone loss and rotation in the left fore. 

I will increase prascend as advised and then retest in 3 weeks. 

Dentist says he is losing weight due to compromised old man teeth. (He is now extremely under-weight)  Denstist advises no hay as he can't chew it sufficiently to ensure he gets the nutrition and also it has become a choke/colic hazard. he advises adding in old man mix such as soaked 'Gumnuts' or 'Old timer'. I've checked gumnuts and they don't have sugar so I'm voting for that. I also have put him on Fibre essentials as a hay replacer - soaks up briliantly into a mush. Still getting the speedibeet and Vit and Min supplement. I have also changed whole linseeds to linseed oil.  Am feeding 4-5 small feeds a day which he is thoroughly enjoying. Is this OK? 

I am tryign to get copies of the photos of Fizzies latest trim. He was unable to weight bear on the left so my wonderful trimmer dug away the dirt from around his right foot so she could trim - he was standing on a mini pedastal. Not ideal but better than nothing. 

IS there anything we can do to support circulation or address bone loss. Someone i have been talking to has mentioned both Boron and chromium as potentially helpful. she has provided this information which I thought was super interesting. 
https://www.getrevue.co/profile/practitioners/issues/boron-a-magical-mineral-issue-16-211535

Boron Soil analysis has confirmed the low levels of this nutrient. The role of boron in humans and animals has long been known to be diverse. An animal’s inability to access boron from their diet will:
1. Reduce the horse’s ability to reduce inflammation – horses with laminitis will be especially prone to an inability to reduce inflammation.
2. Swollen joints will subside very slowly. This is associated with the animal’s inability to synthesise lipoxygenase – an enzyme that helps control inflammation.
3. General movement will be restricted due to the collective effect of the inflammation.
4. Old and young animals will display an inability to maintain bone density and be slow to recover from injury.
5. Sensitive feet, or poor hoof health, is often a problem associated with a lack of boron. This will obviously be exacerbated if the horse is suffering from laminitis.
6. Boron and magnesium are both required to enable a horse to metabolise calcium. Without adequate access to both elements bone loss will steadily accelerate, which often stimulates the development of osteoporosis.
7. If your horse is lacking ‘mental alertness’ and underperforming, then a lack of boron can often be the problem.

Boron often combines with the hydroxyl groups and form corticosteroids, which are known to alleviate symptoms associated with rheumatoid arthritis and joint inflammation. Boron is rapidly absorbed and then excreted in the urine, so its potential for toxicity is minimal. Feeding a proprietary supplement rarely causes a problem, but if your horse has a known kidney problem, then boron intake should be carefully monitored as impaired kidney function could reduce excretion resulting in boron accumulation.

BORON DOSAGES FOR HORSES How much do horses need? Veterinarian Dr J Mullholland recommends feeding about 4g to 5g of borax once per week for each horse as part of an anti-laminitis strategy . Borax contains 11.3% boron, therefore 4g borax provides 452mg boron. I would be inclined to reduce this amount if feeding over a longer period of time especially for long term use.

I discovered this information in relation to seekign answers for my other horse, Harry, who I suspect has Mg deficeincy with recurring muscle spasms, twitching, ongoing soreness, poor movement, uncofrtable backing, and recently found out from dentist very soft teeth. I have had him all his life (from 3 months old) and he has always been NQR. Vet suspects kissing spine (never really been under saddle so not from poor riding posture) but of course doesn't really know why. I am starting to think PSSM - and am trying to work out how to get a test for this. My vet has had no expereince with this. Interstingly, Harry is from a stallion who has had persistent similar symptoms as have his siblings. The breeder has pursued the barteneoulos diagnosis and has put it down to this. 

anyway - lots of information - any help much much appreciated. I am just not ready to give up on Fizzie yet and thank god for this group as I have someone else to ask. 

Bless you (I'm not religious but it seems appropriate for people that are actually saving lives. )

Mandy 


Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974

Hi Mandy, there might be something you can do trim wise to make that left fore more comfortable before giving up.  I just wanted to add to Sherry's comment that although Fizzie's ACTH is in the normal seasonally adjusted range, in horses diagnosed with PPID we find they do best if we don't allow their ACTH to rise seasonally and keep in in the mid 20s or lower year round.  This means increasing pergolide before the seasonal rise to prevent it.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Hi Mandy,
Sorry to hear about Fizzie Iris!  Until we see the X-rays, we can’t offer much advice along those lines, except that small ponies and minis can often do fine with problems you describe as long as the trim is in order.  Going through your case history, I wanted to make sure you are aware that when the horse is doing well on pergolide, as evidenced by ACTH values and symptoms, it means that you have reached an optimal pergolide dose for now.  Do not discontinue the pergolide.  You probably are aware of this now but I’d thought mention it.

I rinse, soak and rinse again any beet pulp I use.  I would suggest adding your hay test results to the folder you made for it.  It should be fine if Carol was able to balance it but excessive iron may indicate it has dirt on it, which you can shake or rinse off.  What are the signs of Mg deficiency your other horse shows?  Is the hay and mineral supplementation the same for that horse as for the pony?

Looking forward to seeing the X-rays.
--

Dear all

Hoping you can help.  My pony Fizzie Iris much worse.  Since reaching out in Jan - we have adjusted his diet as advised by Carol Layton - new diet in Case file. We have also lowered heels etc. I can add new photos to the Case file if wanted. 

We have had EMS test and he is 51 mU/L for insulin and 47.2 pg/ml for ACTH  We put him on Ertuglifozin - L-Pyro - 1.5 ml. This has resulted in massive loss of weight. He appears a bit better, quite perky and alert except in the left fore which continues to show exteme lameness. 

He had a abssess erupt about 1.5 month ago in that left fore, it was under the frog and came out through the heel. I assumed this might alleviate the lameness but it has continued. He stands with his foot tipped forward resting on the toe and is extremely lame. 

We got him xrayed early this week 25 June and it shows extreme deterioration in the left fore - rotation and considerable loss of bone. Vet thinks circulation has been compromised. This is a extreme deterioration to that showed in the Xrays taken in January. The right fore remains the same as that shown in the Jan xrays. Vet suggested PTS as he can not see anything else to do. I wanted to get the expert opinion from this group before doing anything. I have requested the Xrays but they haven't arrived yet. 


https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie/Fizzie%20Iris%20Case%20History%2010.pdf
--
Mandy C, Macedon Australia, 2022
https://ecir.groups.io/g/CaseHistory/files/Mandy%20and%20Fizzie
https://ecir.groups.io/g/CaseHistory/album?id=271974